Promoting Health and Wellbeing of Children and Families Through Relationship Based Interventions

Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. I aim to show how contemporary developmental science points us on a path to effective prevention, intervention, and treatment, with the aim of promoting healthy development and wellbeing of all children and families.

Monday, January 16, 2017

Protesting Trump's Inauguration with Action: Baby Steps

While protests occur across the country in
multiple forms around the inauguration, I will be ensconced at a 5-day Group Relations Conference. While perhaps what I write will come across as justification for my absence from these events, I see this activity as representing a protest of a different kind.

I am attending the conference as part of my new job offering a range of supports
in our local community for the parents of newborns aimed at fostering healthy
relationships from the start of life.

In these troubling times, in addition to gathering in large numbers to show our opposition to the many deeply concerning things our incoming president says and does, I hope that taking small steps every day to support human connection will promote positive change. The following story from my behavioral
pediatrics practice offers an example of one such baby step.

Bonnie's face, darkened by fatigue, communicated
sadness bordering on despair. Living in poverty and alone in caring for her two-week-old
daughter Jasmine after the baby's father abandoned them, she hobbled into my
office, barely managing the weight of the sleeping infant bundled in her
carrier. Bonnie slumped into a chair, unleashing a string of worries about her
daughter's health and her precarious living situation.

Referred to me by a wise colleague who saw the
vulnerability in this pair, their needs seemed overwhelming as I sat quietly, thinking of how best to use our 50 minutes together. I suggested we see what Jasmine could tell us about herself. With Bonnie nodding her assent, I reached for my NBO toolkit.

Early in his work as
a general pediatrician in the 1950s, T. Berry Brazelton, recipient of Obama's Presidential Citizen's Medal, observed the tremendous capacity of the newborn
infant for complex communication. Research based on these observations led to
development of the Neonatal Behavioral Assessment Scale (NBAS). The scale
changed the way both child development experts and pediatricians understood
babies. The Newborn Behavioral Observations System (NBO), a relationship-building tool that has as its core an opportunity for listening without judgment, is a clinical application of the NBAS developed by psychologist J. Kevin Nugent and
colleagues.

While Bonnie held
the sleeping Jasmine in her arms, I performed what are referred to as the
"habituation items" of the NBO. These examine a young infant's ability to protect sleep. When I shone a light in her face and she barely
flinched, Bonnie proudly proclaimed, "She's a great sleeper."

Next we sat on the
floor and, as Jasmine roused herself from a deep sleep, we described our
observations about her movements. "She's so strong!" Bonnie
exclaimed. Her mood shifted gradually as she saw how Jasmine supported her head
while we held her in a sitting position, and then made rudimentary crawling
movements when we placed her on her belly. (As always, I used this as an
opportunity to counsel about having the baby sleep on her back.)

By the time we moved
on to the orienting items and observed how Jasmine turned to her mother's voice
and followed a bright red ball, Bonnie was positively joyful. When she
stood at the front desk to schedule a follow up appointment, her
transformed mood seemed contagious as office staff and other waiting families admired Jasmine and shared in Bonnie's exuberance.

The poverty,
isolation, and stress plaguing this mother-baby pair remain. Addressing these
problems will take both time and broad social change. But in light of the 700
new connections per second a newborn brain makes in the context of caregiving relationships, these 50 minutes could hold
great significance.

I see this visit as
a kind of metaphor. In parallel with large-scale vigilant attention to the
actions of the incoming administration, we must also value taking even the smallest
actions every day against forces of hate and intolerance, moving our world in the
direction of love and human connection.

the baby connects

About Me

I am a pediatrician and writer with a long-standing interest in addressing children’s mental health needs in a preventive model. I have practiced general and behavioral pediatrics for over 20 years, and currently specialize in early childhood mental health. I am the author of The Developmental Science of Early Childhood:Clinical Applications of Infant Mental Health Concepts from Infancy Through Adolescence" ( 2017)"The Silenced Child:From Labels, Medications, and Quick Fix Solutions to Listening, Growth, and Lifelong Resilience" ( 2016) "Keeping Your Child in Mind: Overcoming Tantrums, Defiance, and other Everyday Problems by Seeing the World Through Your Child's Eyes"(2011) " I am on the faculty of UMass Boston Infant-Parent Mental Health Program, William James College, the Brazelton Institute, and the Austen Riggs Center.